European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
-
Talc pleurodesis using talc slurry via chest tube is a primary option in malignant pleural effusion, since life expectancy is short and surgical decortication is hazardous. Incomplete lung expansion after fluid evacuation, and/or excessive fluid secretion predicts failure of pleurodesis. A mini-invasive alternative was investigated. ⋯ An indwelling pleural catheter is a safe alternative for patients with malignant pleural effusion unsuitable for talc pleurodesis. In some, pleural fusion may be achieved.
-
Ocular melanoma prefers to metastasize to the liver and the liver is the sole site of metastatic disease in 80% of patients. Until now there has been no standard treatment available and these patients have a very poor prognosis (median survival 2-5 months). Isolated hepatic perfusion may be an option in patients with irresectable hepatic ocular melanoma metastases. The aim of this study was to evaluate applicability, toxicity and response in this selected group of ocular melanoma patients by treatment with isolated hypoxic hepatic perfusion with retrograde outflow (IHHP) with melphalan. ⋯ Melphalan-based IHHP with retrograde outflow is a safe treatment option for patients with irresectable ocular melanoma metastases. Survival benefit seems to be comparable to classical IHHP.
-
Controlled Clinical Trial
Radioguided occult lesion localization (ROLL) for treatment and diagnosis of malignant and premalignant breast lesions combined with sentinel node biopsy: a prospective clinical trial with 100 patients.
Advanced breast cancer screening techniques and their availability increased the number of non-palpable breast lesions requiring surgery. Consequently reliable and efficient therapeutic management permitting accurate localization and removal of these occult lesions is essential. ⋯ Intra-tumoral tracer injection of for ROLL and periareolar-subdermal tracer injection for simultaneous sentinel node biopsy seem to be a sensitive technique. According to our results ROLL is a safe, precise and simple technique permitting definitive therapeutic removal of malignant or premalignant breast lesions. The high detection rate of the sentinel node in cases with concomitant sentinel node biopsy shows that the combination of both procedures is possible and safe. In our opinion ROLL is an excellent therapeutic option after histological confirmation of malignancy or premalignant disease.
-
The retrosigmoid intradural suprameatal approach includes the standard retrosigmoid suboccipital route with drilling of the petrous bone above and anterior of the internal auditory meatus, allowing for exposure of the trigeminal nerve within the Meckel's cave and of the middle fossa. In this study, the authors analyzed the potential use of an extended variation of the suprameatal route to approach the posterior cavernous sinus for microsurgery of, e.g., petroclival meningiomas and trigeminal schwannomas. ⋯ The extended retrosigmoid intradural suprameatal approach allows exposure of the posterior cavernous sinus and may be used to remove lesions of the posterior fossa extending into the Meckel's cave and into the cavernous sinus.
-
Minimal access breast surgery (MABS) is a procedure that completes breast conservation surgery (BCS) and sentinel node biopsy (SNB) through a single incision. It allows access to axillary sentinel nodes via the breast incision and also provides access to the internal mammary nodes (IMN) as well as other nodal sites when needed. The aims of this study are to describe the MABS approach and to evaluate its safety and efficacy in cases undergoing BCS and SNB (axillary or IMN) for treatment of breast cancer. ⋯ MABS is a feasible option for the majority of women undergoing BCS and SNB and it does not compromise the success of SNB.